Expression of P53 and KI-67 in Benign, Premalignant and Malignant Lesions of Gallbladder: A Comprehensive Review

Abstract

Gallbladder carcinoma (GBC) is an aggressive malignancy that often develops in the context of chronic inflammation, advancing through a sequence of metaplasia, dysplasia, and carcinoma. Differentiating reactive epithelial alterations from genuine premalignant lesions continues to pose a diagnostic challenge, underscoring the necessity for dependable molecular biomarkers.

Objective:

The goal of this review is to put together all the information we have about how the tumor suppressor protein p53 and the cellular proliferation marker Ki-67 are expressed in benign, premalignant, and malignant gallbladder lesions, and to see how useful they are for diagnosis and prognosis.

Methods:

A systematic review of peer-reviewed literature was performed, encompassing studies that evaluated p53 and Ki-67 expression in inflammatory, metaplastic, dysplastic, and malignant gallbladder lesions through immunohistochemistry. We looked at data about expression patterns, labeling indices, and how useful they were for diagnosis.

Results:

Benign and inflammatory gallbladder lesions consistently exhibited low Ki-67 labeling indices and wild-type p53 expression. Metaplastic changes and low-grade dysplasia exhibited slight elevations in Ki-67 and sporadic p53 positivity, indicating preliminary molecular modifications. In contrast, high-grade dysplasia and invasive gallbladder carcinoma displayed significantly elevated Ki-67 indices and robust, diffuse p53 expression, indicating heightened proliferative activity and genomic instability. These trends stayed the same, even though the cutoff values were different in different studies.

Conclusion:

The combined evaluation of p53 and Ki-67 improves the distinction among reactive atypia, premalignant lesions, and gallbladder carcinoma. Their expression is related to how aggressive a tumor is and how it changes into a malignant form, which supports their use as useful additional biomarkers for better diagnosis and early detection, especially in people at high risk.